EoE Treatment Overview Symptoms and causes Diagnosis Treatment Treatment Options for Eosinophilic Oesophagitis (EoE) Eosinophilic Oesophagitis (EoE) is a chronic disorder that can wax and wane. Currently, there is no known cure. There are various symptom management options that need to be discussed with your expert consultant in EoE, as each option has its pros and cons with a variable chance of success and may or may not be suitable depending on your personal circumstances. It is important to note current treatment options vary depending on your country of residence and age. Drug Treatments Topical steroids (budesonide or fluticasone) Topical steroids can quickly reduce symptoms in most patients. They treat the underlying inflammation and may prevent or treat the fibrous narrowing (oesophageal strictures) in some patients with EoE. The treatment is given in the morning and last thing before bed. For those aged 18+ with EoE in the UK, Europe, Canada and Australia, Jorveza® (budesonide orodispersible tablet) is licensed and recommended. This treatment is a specially formulated tablet designed to dissolve in the mouth and not swallowed whole, so the optimal amount of the drug gradually moves to the oesophagus with normal amounts of saliva. Data shows up to 85% resolution of signs and symptoms after 12 weeks, and ongoing reduced-dosage is effective long-term. For EoE patients aged 11+ in the USA, EOHILIA® (budesonide oral suspension) was approved by the FDA in February 2024. For children with EoE and in countries where these specifically designed treatments are not yet available, oral topical steroids are given via either: an asthma-style pump containing fluticasone, which you swallow rather than inhale; or by mixing repsules of budesonide to make a thick liquid, which you swallow to coat the affected area. (See how to make up this thick liquid - sometimes called a slurry). Whichever way the budesonide or fluticasone is administered, pump spray swallowing fluticasone/budesonide slurry or tablet, it is very important that it is not washed off with liquid (drink or food) for as long as possible – preferably overnight but a minimum of 1 hour. Proton Pump Inhibitors, PPI (Omeprazole, Lansoprazole) These drugs are often used for acid-related diseases (of which EoE is not one), and they can partially reduce the symptoms and signs of inflammation on biopsy in up to 50% of patients. Biological Treatments Dupixent®, also known as Dupilumab, is a pioneering biologic medication that targets the signalling pathways of two key cytokines, IL-4 and IL-13, which play a significant role in the inflammatory process. Clinical studies have demonstrated that Dupilumab can significantly alleviate symptoms associated with Eosinophilic Oesophagitis (EoE), such as dysphagia, and is generally well-tolerated by patients. This is a subcutaneous injection which, after initial induction, can be self-administered fortnightly. Unfortunately, this treatment is not available on the NHS for EoE alone but might be prescribed for conditions such as severe (eosinophilic) asthma or severe atopic dermatitis. EOS Network is actively advocating for our community to have access to this as a treatment option. In the United States, the FDA initially approved it for those with EoE aged 12 and above, and in February 2024, this was extended to children 1 to 11 years. The European Union has also approved it for use in EoE patients aged one year and older. The decision to use Dupixent® (Dupilumab) as a first-line treatment varies by country, and it is still usually considered after failure of diet, PPIs, or topical steroids. It is crucial to discuss the most suitable treatment options for your specific situation with your healthcare provider and to revisit these discussions should your circumstances change. Read Published USA Guidelines on Using Dupilumab to Treat EoE patients aged 12+ Other biological treatments are currently in clinical trials. Dietary Treatments Sometimes, the first dietary approach patients adopt is to avoid the types of food that stick. These may not actually be the foods that cause the inflammation but may just be solid types of food (meat or bread) that just get stuck and, as such, may be of little help in treating their condition. Elimination of Foods Triggering the Symptoms or Inflammation Although a natural method, it requires careful avoidance of 1 to 6 or more foods and repeated (up to 7 or more) endoscopies to discover the true reactivity to each food so that a long-term plan can be reached. The common foods linked to the condition which might be excluded include: dairy, wheat, eggs, soya, rice, some fish and some vegetables (legumes). The two most common are Dairy (animal milk produce) and Wheat. A recent study has found that removing animal milk is a reasonable first-line diet therapy option to offer adults with EoE, thus reducing the challenges of cutting out multiple foods where diet is their chosen treatment choice. This finding supports a step-up approach to remove more foods as necessary, it also concludes that other therapies are available for people who did not achieve remission after one or six food elimination diets. During this process, careful attention to nutrition with the help of a dietitian with expertise in EoE is essential to support a structured food exclusion and reintroduction and reassessment plan. It is also important to note although these diets can have a high success rate, they can be difficult to adhere to in the long term. Do patients with EoE benefit from allergy testing? Many of the triggers for Eosinophilic Diseases are non-IgE mediated - (delayed responses) intolerances, which commonly do not show on a skin prick test. However, as 50-60% of Eosinophilic Oesophagitis EoE patients have an atopic (allergic) history, holistically, it is essential to manage any identified IgE-mediated (immediate) allergies such as pollens, dust, foods, etc. It is also important to note that some patients have reported seasonal allergy reactions (hayfever/asthma) to coincide with increased EoE symptoms; further research is needed in this area. Watch presentations on Allergy in EoE - What is the connection? Elemental Formula Diet There is a limited place for an elemental diet (amino acid-based formula) such as Neocate or EO28 in eosinophilic oesophagitis EoE, but only after failure of properly performed medical treatment and/or elimination diet. This is mainly due to the fact that it can be difficult to drink due to its palatability as such, it can require a nasal gastric tube (a tube inserted from nose to stomach) in order to consume the correct amount needed for nutrition. Also, the negative impact on the quality of life when abstaining from all kinds of normal eating, i.e. social and mental impact on the sufferer and their family, must be considered. Watch our specialist dietitian recordings on diets in EoE and how to manage them. Adult Diets in EoE Children and Teen Diets in EoE Dilatation Dilatation is an endoscopic procedure usually performed under sedation. In it, a narrowing (oesophageal stricture) is stretched to widen the oesophagus and allow food to pass through more comfortably. It can be needed if the drugs/management is ineffective and would need to be complemented with a continuation of either a diet or drugs as above. Read up on the latest research in EoE treatments, and register with us to stay up to date with the latest information, updates and opportunities for patients and healthcare professionals: Learn more about EoE treatment and research news Last Updated 14/12/25 Manage Cookie Preferences